The study was undertaken to determine the most adequate tidal volume when used volume preset ventilator during anesthesia. The thirty patients were received controlled mechanical ventilation with constant inspiratory pressure of 10 cmH2O and respiratory frequency of 12/minute. The results were as follows: 1) The PH was 7.39±0.01 and it is within normal limit. 2) The PaCO2 was 34.0±0.6 mmHg and it is a slightly hyperventilatory state. 3) The PaO2 was 228.0±8.2 mmHg. 4) The Buffer base was 20.7±0.3 mEq/L and it is a slightly buffer base deficient state. From the above results. We concluded that if patients were fully relaxed during general anesthesia, it is desirable to maintain the inspiratory pressure of anesthetic mechanical ventilator to 10 cmH2O for adequate alveolar ventilation.
Anesthesia ; Anesthesia, General ; Humans ; Hydrogen-Ion Concentration ; Respiration, Artificial ; Tidal Volume ; Ventilation ; Ventilators, Mechanical*

Hantaviruses are distributed in rodent population world-widely even in geographical areas where hemorrhagic fever with renal syndrome (HFRS) has not been reported. Va.ictus species of Family Muridae and Arvicolidae serve as the natural reservoirs of hantaviruses. Hantaan virus, Seoul virus, Puumala virus, Prospect Hll virus, Sin Hombre virus and New York virus are members of genus Hantavirus and isolated from lungs of A. agrarius, C glareolus, M. pennsylvanicus, P. maniculatus and P. leucopus respectively. This experiment was intended to find the distribution of hantavirus infection among wild rodents and isolate the hantavirus from lung tissue of seropositve Apodemus peninsulae, and compared the nucleotide and amino acid sequences with prototype of hantaan virus 76-118 strain. Hantaviral sequences were amplified from lung tissues of A. peninsulae by reverse-transcriptase polymerase chain reaction. Alignment and comparison of the 324 nucleotide of G2 region of M-genomic segment diverged 4.6% and 0% at the nucleotide and amino acid levels, and complete N protein-coding region of S-genomic segment diverged 3.7% and 1.4% nucleotide and amino acid levels, respectively. This is the report to spill-over on the hantaan virus from A. peninsulae to A. peninsulae in Korea.
Amino Acid Sequence ; Animals ; Gyeonggi-do* ; Hantaan virus ; Hantavirus Infections ; Hantavirus* ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Korea ; Lung ; Muridae ; Murinae* ; Polymerase Chain Reaction ; Puumala virus ; Rodentia ; Seoul virus

Multiple species of muridae and arvicolidae rodents serve as the natural reserviors of hantaviruses. Hantaviruses are distributed in rodent populations world-widely even in geographical areas where hemorrhagic fever with renal syndrome (HFRS) has not been reported. Serologic diagnosis of infection, using hantaviral antigen, indicates that hantaviruses are wider distributed in wild rodents. This study was designed to intended the hantavirus infection among wild rodents captured in Kyebang mountain, Kangwon-do in Korea. A total of 216 wild rodents in 3 species were trapped in July and September in 1995. Serological evidence for hantaviruses infection were tested against five hantavirus antigens by indirect immunofluorescent antibody technique (IFA). Among 100 Eothenomys regulus, 78 Apodemus peninsulae and 38 Apodemus agrarius (IFA). Among 100 Eothenomys regulus, 78 Apodemus peninsulae and 38 Apodemus agrarius; 12 C. regulus, 15 A. peninsulae and 6 A. agrarius were IF antibody positive against hantaviruses. This data suggest that Eothnomys regulus and Apodemus peninsulae would be a natural reservoir of hantaviruses.
Animals ; Diagnosis ; Gangwon-do ; Hantavirus Infections* ; Hantavirus* ; Hemorrhagic Fever with Renal Syndrome ; Korea ; Muridae ; Murinae ; Rodentia*

BACKGROUND: The saddle block with heavy bupivacaine is confinal to the lower lumbar and sacral dermatomes. We reduced the infusion dose of bupivacaine to confine the blocked area to the perineum, and evaluated intrathecal bupivacaine with intrathecal bupivacaine and tramadol or clonidine for their anesthetic and analgesic effect in patients undergoing hemorrhoidectomy. METHODS: Sixty patients (ASA I - II, aged 20 to 55) scheduled for hemorrhoidectomy were divided into three groups. We gave a 0.2 ml placebo (0.9% normal saline) in the control group (n = 20), 0.2 ml tramadol (10 mg) in the tramadol group, and 0.2 ml clonidine (50 microgram) in the clonidine group (n = 20) intrathecally 1 minute after saddle block with 0.5% heavy bupivacaine 2 mg. We compared the effects of the sensory and motor blocks by using the analgesic time and the degree of anal relaxation and the side effects. RESULTS: The analgesic time was greater in the tramadol group than is the control group (P < 0.05), and in the clonidine group if was group then in the tramadol group (P < 0.05) and the control group (P< 0.01). Anal relaxation for hemorrhoidectomy in the tramadol group and the clonidine group was better than that of the control group. The incidence of paresthesia of the foot in the clonidine group (n = 16) was higher than in tramadol group (n = 3) and the control group (n = 1) (P < 0.01). The incidence of patients with urinary retention was significantly lower in the control group than in the tramadol group (n = 3) and the clonidine group (n = 4). CONCLUSIONS: Both bupivacaine 2 mg with tramadol and clonidine were efficient in hemorhoidectomy provided good conditions for hemorhoidectomy.
Bupivacaine* ; Clonidine* ; Foot ; Hemorrhoidectomy ; Humans ; Incidence ; Paresthesia ; Perineum ; Relaxation ; Tramadol* ; Urinary Retention

BACKGROUND: The saddle block with heavy bupivacaine is confinal to the lower lumbar and sacral dermatomes. We reduced the infusion dose of bupivacaine to confine the blocked area to the perineum, and evaluated intrathecal bupivacaine with intrathecal bupivacaine and tramadol or clonidine for their anesthetic and analgesic effect in patients undergoing hemorrhoidectomy. METHODS: Sixty patients (ASA I - II, aged 20 to 55) scheduled for hemorrhoidectomy were divided into three groups. We gave a 0.2 ml placebo (0.9% normal saline) in the control group (n = 20), 0.2 ml tramadol (10 mg) in the tramadol group, and 0.2 ml clonidine (50 microgram) in the clonidine group (n = 20) intrathecally 1 minute after saddle block with 0.5% heavy bupivacaine 2 mg. We compared the effects of the sensory and motor blocks by using the analgesic time and the degree of anal relaxation and the side effects. RESULTS: The analgesic time was greater in the tramadol group than is the control group (P < 0.05), and in the clonidine group if was group then in the tramadol group (P < 0.05) and the control group (P< 0.01). Anal relaxation for hemorrhoidectomy in the tramadol group and the clonidine group was better than that of the control group. The incidence of paresthesia of the foot in the clonidine group (n = 16) was higher than in tramadol group (n = 3) and the control group (n = 1) (P < 0.01). The incidence of patients with urinary retention was significantly lower in the control group than in the tramadol group (n = 3) and the clonidine group (n = 4). CONCLUSIONS: Both bupivacaine 2 mg with tramadol and clonidine were efficient in hemorhoidectomy provided good conditions for hemorhoidectomy.
Bupivacaine* ; Clonidine* ; Foot ; Hemorrhoidectomy ; Humans ; Incidence ; Paresthesia ; Perineum ; Relaxation ; Tramadol* ; Urinary Retention

PURPOSE AND METHODS: Urinary tract infection(UTI) is one of the most important diseases of childhood, especially for young infants. To characterize the patients diagnosed with febrile UTI in their first 6 months of life and to explore the risk factors of recurrent UTI, a retrospective study was performed. RESULTS: Among the 90 patients studied, 77 were boys(86%). First episodes of UTI were diagnosed at the age of 2.5+/-1.4 months. These patients underwent ultrasonographic evaluation of urinary tract(n=90) and voiding cystourethrography(n=81) where 53 and 35 studies showed abnormal findings respectively, and a total of 45 cases of urinary tract anomaly including vesicoureteral reflux(VUR, n=35) were diagnosed. Normal findings on ultrasonography indicated decreased risk of VUR in boys of 1-3 months of age(n=30). 53 patients were followed up more than 6 months and 45 episodes of subsequent UTI developed in 29 patients during the first 6-month period. Patients with relapse were older than patients without relapse at the diagnosis of first UTI, but other clinical parameters including abnormal findings on the imaging studies and prophylactic antibiotics prescription were not different between the two groups. CONCLUSION: UTI in early infancy occurred mainly in male infants and half of the patients had structural anomalies. USG was of clinical value in detecting anomalies requiring surgical intervention, and to rule out high grade VUR in 1-3 months old boys. Results of the imaging study or prophylactic antibiotics could not modify the risk of recurrent UTI.
Anti-Bacterial Agents ; Diagnosis ; Humans ; Infant ; Male ; Prescriptions ; Recurrence* ; Retrospective Studies ; Risk Factors* ; Ultrasonography ; Urinary Tract Infections* ; Urinary Tract*

The nfa1 gene was cloned from a cDNA library of pathogenic Naegleria fowleri by immunoscreening; it consisted of 360 bp and produced a 13.1 kDa recombinant protein (rNfa1) that showed the pseudopodia-specific localization by immunocytochemistry in the previous study. Based on the idea that the pseudopodia-specific Nfa1 protein mentioned above seems to be involved in the pathogenicity of N. fowleri, we observed the effect of an anti-Nfa1 antibody on the proliferation of N. fowleri trophozoites and the cytotoxicity of N. fowleri trophozoites on the target cells. The proliferation of N. fowleri trophozoites was inhibited after being treated with an anti-Nfa1 polyclonal antibody in a dose-dependent manner for 48 hrs. By a light microscope, CHO cells co-cultured with N. fowleri trophozoites (group I) for 48 hrs showed severe morphological destruction. On the contrary, CHO cells co-cultured with N. fowleri trophozoites and anti-Nfa1 polyclonal antibody (1: 100 dilution) (group II) showed less destruction. In the LDH release assay results, group I showed 50.6% cytotoxicity, and group II showed 39.3%. Consequently, addition of an anti-Nfa1 polyclonal antibody produced a decreasing effect of in vitro cytotoxicity of N. fowleri in a dosedependent manner.
Animals ; Antibodies, Protozoan/*immunology ; Antigens, Protozoan/genetics/*immunology ; CHO Cells ; Dose-Response Relationship, Immunologic ; Female ; Hamsters ; Mice ; Mice, Inbred BALB C ; Naegleria fowleri/growth & development/immunology/*pathogenicity ; Protozoan Proteins/genetics/*immunology ; Recombinant Proteins/immunology ; Support, Non-U.S. Gov't

Wernicke's encephalopathy is a reversible but potentially critical disease caused by thiamine deficiency. Most patients complain of symptoms such as ophthalmoplegia, ataxia and confusion. Heavy alcohol drinking is commonly associated with the disease, but other clinical conditions also can provoke it. In pregnant women, hyperemesis gravidarum can lead to the depletion of body thiamine due to poor oral intake and a high metabolic demand. We report a case of Wernicke's encephalopathy following hyperemesis gravidarum in a 36-year-old female at 20 weeks of pregnancy, who visited our hospital because of shock with vaginal bleeding. This case suggests that although the initial presentation may include atypical symptoms (e.g., shock or bleeding), Wernicke's encephalopathy should be considered, and thiamine replacement should be performed in pregnant women with neurologic symptoms and poor oral intake.
Acute Kidney Injury ; Adult ; Alcohol Drinking ; Ataxia ; Female ; Humans ; Hyperemesis Gravidarum* ; Neurologic Manifestations ; Ophthalmoplegia ; Pregnancy ; Pregnant Women ; Shock ; Thiamine ; Thiamine Deficiency ; Uterine Hemorrhage ; Wernicke Encephalopathy*

The purpose of this study is to observe the longitudinal changes in BMI (Body Mass Index) of obese and non-obese 3rd. grade high school students in Seoul for 12 years and to see the trends of overt weight gain in obese adolescents. The results are as follows; 1. The average annual increasing rates of body mass indices in male students were 1.14kg/m2 in obese group and 0.59 in non-obese group. In female students, the average annual increasing rates of body mass indices were 0.93kg/m2 in obese group and 0.53kg/m2 in non-obese group. 2. The change rate of BMI for 12 years was significantly higher in obese group than non-obese group. 3. Puberty had less influence on the change rate of BMI in obese group compared to non-obese group. 4. In obese group, 71.8% of the variance in BMI at 17 can be predicted by BMI at 16 years in male students. In female students 44.4% can be predicted by BMI at age 16. 5. Among the 17-year-old obese students, 58.8% of the males and 56.2% of females were found not to have been obese at 7 years of age. 6. Among the 17-year-old obese students, those who were obese at 7 years of age were found to have higher BMI at later ages than those who were in the non-obese group. Obese adolescents were more likely to be obese in their childhood than non-obese group. There was no optimal age for the significant weight gain and the increasing rate of BMI was constantly higher in obese group than in non-obese group. Due to the fact that child obesity in early age contributes to obesity in adolescence, close observation is advised on the other hand, a large proportion of obese adolescents can be preventable by early interventions, because about 50% of obese adolescents were not obese in early elementary school age.
Adolescent* ; Body Mass Index* ; Early Intervention (Education) ; Female ; Hand ; Humans ; Male ; Pediatric Obesity ; Puberty ; Seoul ; Weight Gain